Rwanda’s Bold Step Towards Universal Health Coverage: Inside the New Health Sector Strategic Plan

In a major step toward achieving universal health coverage by 2030, the Government of Rwanda, through the Ministry of Health, launched the Fifth Health Sector Strategic Plan (HSSP V) (2024/25–2028/29) on Friday, January 31, 2025.
This comprehensive strategy builds on the remarkable progress of HSSP IV (2019–2024), reinforcing Rwanda’s commitment to strengthening its healthcare system for the future.

During his speech, Dr. Yvan BUTERA, Rwanda’s Minister of State for Health, emphasized Rwanda’s progress in healthcare and the importance of continuing to improve the quality and accessibility of services.
He noted, “Healthcare is not just a service, but it is a promise” and highlighted the significant expansion in coverage, especially in critical areas like cancer care and complex surgeries, which are now covered by community-based health insurance.
He also addressed the challenges, including preventable deaths, emphasizing that “we shouldn’t face any death which we can prevent.”
Butera stressed the ongoing improvements in healthcare infrastructure, citing the increase in trained specialists, particularly in obstetrics and gynecology, with plans to replicate this success in other specialties.
He highlighted key health achievements in Rwanda, stating, “Close to 95% of babies now is delivered in health facilities with skilled birth attendants,” and neonatal deaths have decreased by 1.5%.
He noted that preventable diseases, including malaria, have seen a significant decline, with malaria cases dropping by 85%.

Butera also celebrated Rwanda’s success in HIV targets, with 96% of people living with HIV knowing their status and 97% achieving viral suppression. Despite these strides, he emphasized ongoing challenges, including chronic malnutrition and under-five mortality. He encouraged continued focus on increasing life expectancy, aiming for a 15-year gain.
He said, “We want to see it in other critical areas like surgery, anesthesia, critical care, emergency medicine.” He also called for better emergency medical services to prevent deaths in critical situations, particularly during the “golden hour.”
The Minister underscored the need for better health financing and resource mobilization, alongside a focus on digitization to improve decision-making.
He concluded by introducing Mission 2027, aiming to eliminate cervical cancer by 2027, stressing the importance of vaccination and screenings. “Let today be a moment of renewed commitment,” he urged, calling for collective action from all sectors to achieve these goals.

Noela BIGIRIMANA, Deputy Director General at Rwanda Biomedical Center (RBC), emphasized Rwanda’s commitment to equitable healthcare, stating, “Every Rwandan resident has the right to the highest level of health.”
She highlighted RBC’s role in implementing the Ministry of Health’s vision by leveraging strategic partnerships to advance scientific knowledge.
“Scientific knowledge is a building block that you can use to improve the kind of services that we provide,” she noted.
Bigirimana underscored RBC’s focus on innovation, including genomics and precision medicine, as part of Rwanda’s ambitious yet practical strategic plan (HSSP-5). Citing the Marburg outbreak response, she stressed the importance of science in guiding surveillance, treatment, and vaccine deployment, reaffirming RBC’s commitment to advancing healthcare through research and technology.

Dr. Athanase RUKUNDO, Head of the Clinical Service Department at the Ministry of Health, outlined how clinical and public health services are streamlining the implementation of HSSP-5 through policies, guidelines, and standards.
“As you know, clinical and public health play a key role in this implementation,” he stated, emphasizing coordination between the Ministry and partners. He highlighted efforts to align policies with the health sector strategic plan, revise healthcare laws, and standardize treatment guidelines.
Key initiatives include expanding healthcare services, introducing AI-enabled ultrasounds to reduce maternal mortality, digitalizing health facilities to improve efficiency, and strengthening community engagement. “We can avail the service but when the population is not part of the equation, we cannot achieve this,” he noted.

Fred Manzi MUKOMBOZI, Budget Management and Reporting at Ministry of Finance and Economic Planning (MINECOFIN), emphasized the government’s commitment to financing the Health Sector Strategic Plan (HSSP V) in alignment with Vision 2050 and NST2.
He reaffirmed that “the health sector remains a top priority for financing,” and stressed the importance of strategic resource allocation to maximize returns on investment.
Mukombozi highlighted the need for efficiency in budget allocation, stating, “When we’re doing the budget allocation, we have to focus on those interventions that give high impact and returns on investment, because at the end of it all, we want to ensure the value for money.” He also underscored the role of expenditure tracking to prevent financial leakages and ensure transparency.
To address funding gaps, he pointed out sustainable financing measures, including mobilizing more resources, expanding social health schemes like CBHI, and promoting public-private partnerships (PPPs). “We want to see the private sector again engaging in health services,” he said, calling for stronger collaboration with development partners.
Mukombozi also emphasized the importance of strengthening digital financial management systems and preparing for financial shocks, such as pandemics, to ensure long-term sustainability in health financing.

Renata Tallarico, Deputy Representative of the United Nations Population Fund (UNFPA) Rwanda, emphasized the potential of the HSSP V to transform Rwanda’s health system.
She stated, “HSSP V is actually an opportunity to reflect… but also to see what different we can do, and I think how different we can act.”
She highlighted the importance of primary healthcare as foundational to the system, stressing the need for integrating areas like sexual and reproductive health, a core focus for UNFPA.
She also pointed out that the successful implementation of HSSP V depends on involving communities, particularly at the district level, where “the actual operationalization of what we have co-created is actually at that level.”
Renata spoke about the role of innovation in healthcare, particularly the concept of self-care to reduce the burden on face-to-face service delivery.
She noted, “I think the great aspect of challenges is that they can be easily seen as opportunities.”
She also mentioned the need for sustainable health financing, referencing the Thousand Health Coast Initiative, and highlighted the importance of technology in Rwanda’s health system. However, she warned against relying solely on technology, citing the digital divide and the need for a comprehensive, multisectoral approach.
Concluding, she said, “This is a great opportunity for all of us to really be able to start afresh with new learnings.”

Nicole Curtis, Public Health Advisor at Belgian Development Agency, Enabel, discussed the Enabel’s approach to aligning with the HSSP V through result-based financing.
She emphasized, “The advantage of that modality is that it supports through alignment to one plan, the HSSP V, to one budget, the budget using the system, and also using the same MRE matrix.”
This alignment ensures that indicators for financing are consistent with the HSSP V. Enabel’s interventions also benefit from lessons learned from HSSP IV, particularly through collaboration with the French Development Agency. One notable project is the Nyarugenge Phase 2 District Hospital, where Enabel is enhancing infrastructure and providing state-of-the-art medical equipment. Nicole stressed the importance of proper maintenance: “there’s no need to have all that if it can be maintained properly.”
She also highlighted Enabel’s work at both the district and community levels, ensuring alignment between local and central divisions. Furthermore, Enabel collaborates with the RBC to establish a regional center of excellence in public health, using technology and data to support research and policy adjustments.



